A new study published in the journal Circulation finds that hospitalizations for heart attacks declined in Pueblo, Colorado, after the city implemented a comprehensive smoke-free workplace law, including restaurants and bars, on July 1, 2003. The new study is consistent with findings of an earlier study that found heart attack hospitalizations declined in Helena, Montana, during the six months that city’s smoke-free law was in effect in 2002. These studies add to the overwhelming evidence that secondhand smoke poses serious, even life-threatening risks to health and provide further reason to conclude that smoke-free laws deliver immediate, significant health benefits. The more we learn about the dangers of secondhand smoke the more unacceptable it becomes for anyone to be exposed to these hazards in order to earn a paycheck or go out to a restaurant or bar. State and local elected officials have a growing obligation to enact smoke-free laws that protect everyone’s health and right to breathe clean air.

The new study compared the number of heart attack hospital admissions in Pueblo during the 18 months before and the 18 months after the city’s smoke-free law took effect on July 1, 2003. While the authors were careful to state that the study does not prove a causal relationship between smoke-free workplace laws and reductions in the incidence of heart attacks, it found a 27 percent decrease in the number of heart attacks in Pueblo after the law took effect, while there was no significant change in the rate of heart attack hospitalizations in an adjacent county that did not have a smoke-free law. The study’s authors concluded that the fact that both this study and the earlier study conducted in Helena, Montana, both found a significant decline in hospital admissions for heart attacks supports the conclusion that smoke-free laws may result in a reduction in heart disease.

The Pueblo study reinforces the earlier Helena findings in significant ways. It involved a sample size three times larger than the one used in Helena and was conducted over a longer period of time. The Helena study, published in the British Medical Journal in April 2004, found that the number of heart attack hospitalizations fell by 40 percent during the six months Helena’s smoke-free law was in effect, but rose to previous levels after the law was suspended due to a legal challenge. Together, these studies provide compelling new evidence that smoke-free laws may improve health and save lives far more quickly than previously thought.

The Pueblo study adds to the mountain of evidence that secondhand smoke poses a serious threat to human health. As the U.S. Surgeon General concluded in a groundbreaking report on secondhand smoke issued on June 27, “The debate is over. The science is clear: Secondhand smoke is not a mere annoyance, but a serious health hazard that causes premature death and disease in children and nonsmoking adults.” The Surgeon General found that secondhand smoke is a proven cause of lung cancer, heart disease, serious respiratory illnesses such as bronchitis and asthma, low birth weight and sudden infant death syndrome. The Surgeon General also found that secondhand smoke is responsible for tens of thousands of deaths in the United States each year and that there is no risk-free level of exposure.

The Surgeon General’s report also confirmed that smoke-free laws protect health without harming business. Dozens of studies and hard economic data have shown that smoke-free laws do not harm sales or employment in restaurants and bars and sometimes have a positive impact. Some of the strongest evidence comes from New York City, where a report found that, in the year after the city’s comprehensive smoke-free law took effect March 30, 2003, business receipts for restaurants and bars increased, employment rose, the number of liquor licenses increased, virtually all establishments are complying with the law, and the vast majority of New Yorkers support the law.

In response to all of this health and economic evidence, 14 states, Washington, DC and Puerto Rico have now passed smoke-free laws that include restaurants and bars. The states are: California, Colorado, Connecticut, Delaware, Hawaii (effective Nov. 16), Maine, Massachusetts, Montana, New Jersey, New York, Rhode Island, Utah, Vermont and Washington (the Montana and Utah laws extend to bars in 2009, while the DC law does so on January 1, 2007). Hundreds of cities and counties and even entire countries have also passed strong smoke-free laws.